Local Authority (Overview and Scrutiny committees Health Scrutiny Functions) Regulations 2002

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Mr. Simon Burns (West Chelmsford): As the Committee knows, the purpose of the first set of regulations is to make provision for the health scrutiny functions of overview and scrutiny committees under the Health and Social Care Act 2001. This is the first opportunity to debate in Committee the arrangements that will lead to the abolition of community health councils. During the passage of the legislation, my hon. Friends and I thought such a move was a grave mistake by the Government, and we have not altered our view in light of these regulations.

Community health councils will be abolished on 1 September. I am worried that the arrangements made for their replacement, which will give bodies the power to scrutinise and overview, and the ability to react to and help individuals with complaints against what they perceive to be inadequate or poor treatment by the national health service, will not be up and running on 1 September in order to enable the provision of a seamless service.

As the Minister may know, on 11 April, Lord Hunt gave the following assurance in another place:

    ''Between now and the abolition of CHCs we shall work closely with all those organisations to ensure no gaps are left in the system. CHCs will not be abolished until we are confident all their functions have been picked up in the new system: independent advocacy by independent complaints advocacy providers; scrutiny by OSCs; and monitoring of local services by patients forums. There will be a managed transition to all parts of the system.''-[Official Report, House of Lords, 11 April 2002; Vol. 633, c. 629.]

However, the reality is far from that glib assurance given in another place. The new system, which will replace CHCs with different commissions, committees and patients forums, will not be in place in an effective way when CHCs are abolished on 1 September. There is likely to be a significant hiatus after that, during which, in many areas of England, there will be no effective monitoring of the NHS on patients' behalf. No patient representatives will sit on NHS trust boards and there will be no consultation with patients on major changes to the health service.

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The establishment of OSCs by local authorities is not mandatory. Many local authorities have not set them up, or even begun to, with the result that there will be no scrutiny of the NHS at local government level and hence no onward referral to the Secretary of State of controversial decisions on changes. It is unacceptable that in some areas of the country after 1 September there are likely to be few or no organisations with a statutory right to inspect the NHS. Parts of the national health service will therefore not be monitored at all next winter. There will be no patient voice on NHS boards, no patient perspective brought to NHS decisions and no patient perspective on public consultations. To my mind, the misguided and disingenuous assurances given in another place tarnish the whole of the Government's approach. How can we accept future assurances with any good faith, given the assurances that Lord Hunt gave?

Every month, as the Minister knows, some 11,700 patients make a complaint against the NHS. We must therefore ask whether the independent complaints advisory service will be fully up and running by 1 September. If not, for an indefinite period large numbers of patients will go without the assistance that they need. That is simply unacceptable.

According to Lord Hunt, the abolition date for CHCs was chosen because they are rapidly losing staff and members. Will the Minister explain how the Government know that? Can he provide figures to justify that assertion? If staff are leaving CHCs, it must be due to uncertainty combined with a lack of communication. Why have the Government taken so long to announce when CHCs will be abolished? The announcement has been made only in the relatively recent past. The Government should have ensured that members and staff of CHCs felt that their worth was more highly regarded and that their positions were more worth while, and given them more notice. The Government should have ensured that the establishment of the replacement bodies, such as OSCs, was moving ahead uniformly throughout the country, in order for them to be up and running in time for a seamless transfer of CHCs' functions.

Mr. Harry Barnes (North-East Derbyshire): On the transfer and ensuring that no gaps are created in moving from one system to another, should not great use be made of the expertise on community health councils, so that they are on board and involved in the transfer? The indication in North Derbyshire is that that has never occurred.

Mr. Burns: I am grateful to the hon. Gentleman, because he is absolutely right. Scores of people throughout the country have given dedicated service, gaining experience and expertise in community health councils. The health service and individual patients could have benefited if the talents of those people had been used in a better move, in the future, from CHCs to the new system. However, as the hon. Gentleman suggests, that has, sadly, not been given enough attention and detail. I am fearful that many people will be lost from that aspect of health service monitoring and work because they are not prepared or able to hang around waiting for what might or

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might not happen, and have sought other NHS positions.

The Parliamentary Under-Secretary of State for Health (Mr. David Lammy): I want to make clear to the hon. Gentleman that the regulations with which we are presently dealing pertain to the overview and scrutiny committees, which came into being on 1 January. There is, therefore, no gap. There are other regulations, which we may come to later this afternoon, pertaining to the abolition of CHCs, but I want to make it clear that there is not the gap that the hon. Gentleman suggests. The OSCs were set up on 1 January and are taking shape around the country.

Mr. Burns: Although I accept that those committees have been set up in theory, in reality they are not all up and running and operating as one would expect. Too little attention has been paid not just to OSCs but to other parts of the equation for replacing CHCs to provide a proper, seamless system for patients and to monitor what goes on in the NHS locally.

Mr. Lammy: CHCs had several functions, but as the debate on these regulations pertains to overview and scrutiny, what is relevant relates to the statutory consultation function. We may discuss issues relating to complaints or monitoring and review later. In this debate, we are concerned with the statutory duty to consult. The hon. Gentleman says that he is concerned that these powers have not been taken up, but they are powers that local authorities have to undertake in all areas, including his.

Mr. Burns: I am grateful for the Minister's elaboration but in certain parts of the country the system established under these regulations is not moving forward as effectively as one would expect. I am not convinced that there have been no gaps in implementing the proposals, which is unfortunate. The bottom line-I stay close to that view-is that CHCs should never have been abolished in the first place. However, I will not test your patience by re-hashing old arguments, Mr. Atkinson, as you would rightly haul me up for doing so.

The Government have not kept to the spirit of the assurances given in another place by Lord Hunt. The method in which the OSCs were set up was not the best possible and there was a lack of consultation. It is most unfortunate-

4.58 pm

Sitting suspended for a Division in the House.

5.13 pm

On resuming-

Mr. Burns: Before we broke for the Division, I was saying that there is a concern that the overview and scrutiny committees are not being established throughout the country in a uniform and sensible way. If the Minister were concerned about the establishment and initial operation of OSCs, would he be prepared to examine ways of improving that in the areas in which there is a weakness?

My next point was also raised by the hon. Member for Oxford, West and Abingdon (Dr. Harris). Like him, I was surprised at the astonishing omission in

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regulation 4(2), which is that OSCs are not to be consulted on the establishment or dissolution of NHS trusts or primary care trusts. Will the Minister justify that omission? As I am sure he would appreciate, both such changes in a local area would be fundamental, and under their regime CHCs had the power to comment and seek the advice of local communities on such far-reaching issues. It seems extraordinary that that power has not been transferred to the OSCs, and I hope that the Minister will reconsider that.

Finally, I want to ask about the consultation process that OSCs will have with the general public. No time scale is given in the regulations for the period of consultation, which is an omission. It may be a reasonable omission that the Minister can explain, but if one wants to consult the public-or anyone else-the time scale for the process should be established. If it were, people would have an opportunity to contribute if they had strong and serious views, and we could ensure that the consultation was not rushed but done properly, so that it was truly reflective of the views of local communities.

5.16 pm

Dr. Richard Taylor (Wyre Forest): I have one comment and one question on the regulations. Despite the welcome addition to funds for the NHS, it appears that many PCTs are heading for a huge underfund or overspend at the end of this year. In particular, Worcestershire will be 16 million in the red. Overview and scrutiny committees are urgently required, as they should be scrutinising exactly such problems.

I want to reinforce the question put by the hon. Member for Oxford, West and Abingdon to ensure that we get a reply. How many local authorities are well on the way to getting their scrutiny committees going and how many are dragging their feet? Shropshire is doing well, but Worcestershire is dragging its feet. Can we have some numbers, please?

5.17 pm

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